Little Leaguer’s Shoulder

With the world series currently being played, many young athletes will have dreams of becoming a professional baseball player. Dr. Nabil Ebraheim, an orthopaedic Surgeon from The University of Toledo Medical Center, has a few thoughts on the subject. Dr. Nabil Ebraheim has over 30 years of orthopaedic experience and has seen and treated many different injuries over the years.

The “little leaguer’s shoulder” is a stress fracture of the growth plate of the proximal humerus. It usually occurs due to a throwing motion and is considered to be a fracture of the physeal growth plate (Salter-Harris Type I).

The overuse, repeated high loads of torque and rapidly growing child causes microtrauma to the physis. This injury is seen mostly in adolescence, pitchers and tennis players. This overuse injury is associated with pitching and is influenced by the quantity, intensity and age of the player.

Symptoms: Shoulder pain that worsens with throwing as well as tenderness over the physis of the proximal humerus. Rule out an injury to the subdeltoid bursa. The pain will usually improve with rest.

X-rays will show a widened physis compared to the other side. There will be fragmentation and sclerosis of the lateral aspect of the proximal humerus in the physeal area.

Treatment of little leaguer’s shoulder includes cessation of throwing for about 2-3 months, progressive throwing program, rotator cuff strengthening once full painless range of motion is achieved.

omplications that may arise with little leaguer’s shoulder. These complications include both premature growth arrest and a physeal fracture.

To prevent little leaguer’s shoulder from happening to a young athlete, Dr. Nabil Ebraheim suggests that these athletes avoid overusing their arm.


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